MOST™

Marshalla Oral Sensorimotor Test™

by Pam Marshalla, M.A., CCC-SLP
-
Ages 4;0+

MOST: Examiner's manual, test easel, 30 Record Forms, 30 Case History Forms, all the oral-motor supplies to give the test, and a sturdy tote bag. (2007)

The Marshalla Oral Sensorimotor Test (MOST) is a comprehensive and quick assessment designed to put a numerical value on oral movement, oral-tactile sensitivity, facial and oral tone, as well as basic respiration, phonation, and resonation skills. The MOST is the first exam to allow speech-language pathologists an opportunity to place a numerical value on the oral exam.

Clients

The MOST identifies jaw, lip, and tongue movement problems. It is optimal for children with concomitant feeding difficulties, neurological deficits, developmental disorders, and sensory processing disorders. It is appropriate for children four years and older.

Scores

The MOST provides an Overall Oral Sensorimotor Score as well as individual scores on subtests. You may use the scores to measure pre- and post treatment abilities. This easy-to-use evaluation allows the therapist to identify strengths and weaknesses in the following areas:

Jaw Movements

Lip Movements

Tongue Movements

Oscillating Jaw, Lip, and Tongue Movements

Oral and Facial Tone

Respiration and Phonation Skills

Resonance

Oral-Tactile Sensitivity

Subtests

The subtests of the MOST allow the examiner to look closely at individual areas of speech motor control.

The Motor Function subtests of the MOST are designed to assess a client's control of jaw, lip, and tongue movements and praxis through 21 simple probes.

The Sensory Function subtest measures the client's responses to incoming tactile stimulation to various areas inside and outside of the oral cavity using multiple textures in 8 simple probes.

The Respiration and Phonation subtest provides a child-friendly examination of basic respiration and phonation skills using kazoos and whistles.

The Resonation subtest allows the examiner to put a numerical value of the characteristics of hyper- and hyponasality.

The Oral and Facial Tone subtest provides two simple procedures for specifying muscular tone in the face, lips and tongue.

Report Writing

Speech-language pathologists often write general observations about respiration, phonation, resonation, and oral movement. The MOST allows speech-language pathologists to provide scores to back up their claims. See examples offered in the table below:

Test Area

Typical Report Statement

MOST Report Statement

General Oral Movement

"John did not move his oral mechanism well."

"John achieved a score of 5/21 on the Motor Function subtest of the MOST, indicating very poor control of jaw, lip, and tongue movements."

General Oral Movement

"John didn't seem to have any problems moving his mouth."

"John achieved a score of 21/21 on the Motor Function subtest of the MOST, indicating excellent control of jaw, lip, and tongue movements."

Oral-Tactile Sensitivity

"John did not like to be touched around his mouth."

"John achieved a score of 1/8 on the Sensory Function subtest of the MOST, indicating limitations in his ability to tolerate tactile stimulation to the oral mechanism."

Tongue Movement

"John demonstrated poor control of tongue movement."

"John scored 2/8 on the Tongue Function subtest of the MOST. He failed all items related to tongue placement."

Respiration

"Breath support was questionable."

"John scored 1/9 on the Respiration and Phonation subtest of the MOST. He failed all tests of basic skill in inhalation and exhalation."

Resonation

"John appeared hypernasal."

"John scored 1/5 on the Resonation subtest of the MOST. He was hypernasal on vowels and fricatives, and he demonstrated nasal bleed across phonemes."

The MOST research study sample included 160 children, ages 4;0 to 7;11 from across the United States. Data from this sample is the basis for the five subtests and the four sections of the Motor Function subtest.